In the 25 years I’ve been a nurse, I come to realize that for nurses to effectively care for patients and leave work feeling good about the work they do, we need 3 Rs for Nurses:
Resources, Recognition, and Respect
In this post, I will share how having the right resources can make all the difference in whether or not we can do our jobs well.
A few years ago, I took a leap of faith and went back to the bedside. I worked just a few days per month on a unit that I thought would be a good fit but turned out to be a nightmare. The patients were so acute, which really wasn’t the problem. The problem was that we didn’t have the resources to effectively care for our patients. For this and other reasons, I left. I now work on a unit where patients are a bit less acute and I love it!!! The biggest difference is that we (nurses) have the resources we need to actually function as nurses.
Two differences stand out the most.
Hospital A – When our patients were ordered tests, an escort would arrive on the unit to transport them. But here’s the issue – the NURSE had to get the patient on the stretcher and have the patient ready within 5 minutes upon the escort’s arrival to the unit. If we weren’t ready, escort would leave and we would have to re-request them. I cannot tell you how much time I spent trying to get my patients on a stretcher or wheelchair.
Hospital B – When our patients are ordered tests (CT scans, XRay, Stress Test, etc), escort finds the nurse, asks if the patient can go, gets the patient ready, and takes the patient down. Period.
A good nursing assistant will make or break our ability to give good patient care. They are a valuable resource to the nurse and play a critical role in patient care.
Hospital A – on a 32-bed unit, we only had 2 nursing assistants. That meant, 17 patients apiece. Many patients were in isolation and required total care. Oh, if a patient needed a sitter, guess who got pulled to sit. Yep. One of our nursing assistants, leaving us with only one. Once, I was suctioning a patient in an isolation room. I kept hearing call bells going off. Then, the charge nurse stopped by my room to tell me my patient was vomiting but that our nursing assistant just got pulled to sit. My poor patient had to wait until I finished to get any help. Ugh. When we got admissions, as soon as the patient hit the floor, the NURSES had to meet the patients, put them into bed, put on the telemetry wires, pulse ox, etc.
Hospital B – Even though our acuity and number of beds is less, we have 2-3 aides per shift. Our NAs are amazing!!! They take care of everything – hygiene, meals, BGMs, ambulation, etc. Our NAs are contacted when we get an admission. They get the patient into bed, attach the telemetry wires, pulse ox, etc., get a set of vitals and THEN find us to tell the patient is situated.
Again – RESOURCES!!!
Disclaimer – I’m NOT saying that nurses are not capable of doing escort or aid work. What I am saying is that in our increasingly complex healthcare environment, nurses need adequate support from others so that we can do what only nurses can do – assess, evaluate, teach, etc.
A few weeks ago, I was in my patient’s room giving medications. The escort walked into the room and asked if my patient could go to radiology for her CT Scan. I said yes but asked if she could wait until I finished administering medications. She said no problem. As soon as I finished, I started to help my patient get into the wheelchair. The escort said, “I’ll do this. I’m sure you have other patients to take care of.” And I did. What did I do with that “extra” time? I looked up my patient’s lab work, saw that the INR was high, and then looked at the trend – started therapeutic (2.6), but then continued to rise (3.9) over the course of 2 days. I checked the physician’s progress note from the morning but didn’t see any notation about the INR. So, I called him. Apparently, he didn’t notice it, changed the evening dose of Coumadin, and then thanked me for pointing it out to him.
That’s how nurses articulate their value – we work collaboratively with other members of the healthcare team to effectively care for patients.
With resources, we can do this. Without them, we can’t.
Many nurses advocate for appropriate staffing ratios – I get that, but we can’t always secure the nurses we need, especially during a nursing shortage.
If you’re not staffed appropriately, in addition to helping to get more nurses in the door, advocate for more RESOURCES.
Questions to consider?
What do you spend a lot of time doing that frustrates you (ex. getting patients on stretchers for testing)?
What would you do with the extra time if you had the resources you need (I’m hoping it involves pt. care)?
What RESOURCES do you need so that you can articulate YOUR value?
I’d love to read your comments about this issue.
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About the author: Dr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate bullying behavior. To find out how you can bring Renee to YOUR organization.